1. Women who have had up to four previous pregnancies and carried each beyond 20 weeks of gestation (grand multiparity)
2. Women with twin pregnancy or higher multiples.
3. Women who have been diagnosed with diabetes mellitus (Types I and II) prior to getting pregnant, or had diabetes mellitus during previous pregnancies (gestational diabetes).
4. Women who have chronic hypertension outside pregnancy, or any hypertensive disorder, such as pre-eclampsia, in past pregnancies.
5. Women who are underweight or obese at the time of getting pregnant.
6. Women who are living with physical or intellectual disabilities, eg. Paraplegia, cerebral palsy, etc.
7. Women who conceived through assisted reproductive techniques or natural conception after a long history of infertility with no living child, aka “precious baby”.
8. Women who have anatomic anomalies within the uterus (which predispose them to miscarriages)
9. Women who have fibroids coexisting with pregnancy.
10. Women who have cancer, or had cancer which was treated shortly before they got pregnant.
11. Women below 18 years of age or
above 35 years.
12. Women who have had a Caesarean section before.
13. Women who bled profusely following previous births (Postpartum haemorrhage)
14. Women who had any surgery that involved cutting through the inside of the womb (eg. Removal of submucous fibroids)
15. Women who had a ruptured uterus during a previous pregnancy (usually during labour).
16. Women who have had a stillbirth or early neonatal death.
17. Women who have had at least 2 consecutive miscarriages.
18. Women who had preterm labour with or without preterm delivery.
19. Women whose previous babies weighed below or above the expected normal birth weight for gestational age.
20. Women whose previous babies had congenital anomalies such as neural tube defects or genetic syndromes such as Down syndrome.
21. Women who developed shoulder dystocia (difficulty in delivering the baby’s shoulder after the head has been delivered) in the past delivery.
22. Women who had severe (Third or fourth-degree) perineal injuries during previous childbirth.
23. Women who have history of obstructed labour, with or without a urinary fistula.
24. Women who had any other complication worthy of note in the past pregnancy (such as placental abroption, etc.)
25. Women who have any other chronic, latent or recurrent infectious diseases, such as HIV/AIDS, Hepatitis B or C, Syphilis, Herpes, human papilloma virus, genital warts, etc.
26. Women who are currently on treatment for any chronic medical condition such as Sickle cell disease, cardiac disease, kidney disease, thyroid disease, autoimmune disorders, epilepsy, etc.
27. Women living with mental illness such as depression, schizophrenia, substance abuse, etc.
These groups of women should attend preconception clinics before attempting to get pregnant. Also, they must be monitored by experienced specialists throughout pregnancy and beyond…
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